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皮肌炎是一种皮肤与肌肉的弥漫性炎症.皮肤表现为红斑、水肿;肌肉表现为无力、疼痛与肿胀;可伴有全身症状以及脏器损害如心肌炎等,并发心包积液者较少见,我们曾遇1例,现报告如下.患者,女,56岁.因面部皮损,四肢疼痛无力2年,加重时伴心慌、胸闷、双下肢浮肿半年,于1994年6月18日入院.患者于2年前发现面部、眼睑皮肤红斑、肿胀,皮肤增厚,2～3个月后皮肤由红逐渐变为黄色,变硬呈桔皮样损害.在发病同时伴有四肢肌肉酸疼,双手不能持重物,双下肢疼痛伴轻度水肿.行走无力,且不能下蹲,蹲下时亦不能站起.近半年来出现劳力性心慌、胸闷,夜间不能平卧,下肢水种更甚.时有发作性心前区疼痛,并放射至咽部.服心痛定、利尿剂等,但疗效不佳而来我院就诊.体检:T36.7℃,P98次/分,R26次/分,BP14/10kPa.肥胖体型,呼吸稍促,口唇轻度紫绀,面部皮肤桔皮样损害,增厚,粗糙较硬,浅表淋巴结无肿大;颈静脉充盈;心前区无隆起,心尖搏动不清,心界向双侧扩大,心音遥远,心率120次/分,心律尚规整,未闻及杂音及心包摩擦音.双肺呼吸音粗,可闻及少许干湿性啰
Dermatomyositis is a diffuse inflammation of the skin and muscles. The skin is characterized by erythema and edema. Muscle performance is weakness, pain and swelling. It may be associated with systemic symptoms and organ damage such as myocarditis, and less pericardial effusion See, we have encountered a case, the report is as follows .Patients, female, 56 years old .Because of facial skin lesions, limb pain and weakness 2 years, increased with palpitation, chest tightness, edema of both lower extremities, admitted to hospital on June 18, 1994 2 years ago, the patient had erythema on the face and eyelid, swollen skin and thickening of the skin. After 2 to 3 months, the skin gradually changed from red to yellow and hardened to cause orange peel-like lesions. , Both hands can not hold heavy objects, both lower extremity pain with mild edema. Walking weakness, and can not squat, squatting also can not stand up .For nearly six months appear labor palpitation, chest tightness, night can not lie down, There are occasional episodes of pre anorectal pain and radiation to the pharynx. Serving heartache, diuretics, etc., but the curative effect from our hospital. Physical examination: T36.7 ℃, P98 beats / min, R26 beats / min , BP14 / 10kPa. Obese body type, breathing a little faster, lips mild cyanosis, facial skin orange peel damage, thickening, rough hard, Superficial lymph nodes without swelling; filling of the jugular vein; no anterior erection, apical beating, the heart to bilateral enlargement, distant heart sounds, heart rate 120 beats / min, heart rate is still regular, unheard noise and pericardial friction rub. Breath sounds coarse lungs, can be heard and a little dry wet Hello